美沙酮、QTc间期延长与尖端扭转型室性心动过速：当前概念、管理及故事中的一个隐藏转折？
Methadone, QTc prolongation and torsades de pointes: Current concepts, management and a hidden twist in the tale?
作者信息
Mujtaba Sobia, Romero Jorge, Taub Cynthia C
机构信息
Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461-1138, USA.
Division of Cardiology and Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467-2400, USA.
出版信息
J Cardiovasc Dis Res. 2013 Dec;4(4):229-35. doi: 10.1016/j.jcdr.2013.10.001. Epub 2013 Nov 16.
Abstract
Methadone is a drug that has found widespread utility in the management of opioid addiction and pain. Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of the QT interval and an increased risk of torsades de pointes. In this article we will give a brief overview of the long QT syndromes, followed by an in-depth look at the current pathophysiologic mechanisms of methadone induced QT prolongation, a review of the existing literature and the current concepts regarding the prevention and management of methadone induced torsades de pointes. In addition, we explore the idea and implications of a genetic link between methadone induced prolongation of the QT interval and torsades de pointes.
摘要
美沙酮是一种在阿片类药物成瘾和疼痛管理中广泛应用的药物。随着其广泛使用，美沙酮也因导致QT间期延长和尖端扭转型室速风险增加而声名狼藉。在本文中，我们将简要概述长QT综合征，然后深入探讨美沙酮诱导QT间期延长的当前病理生理机制，回顾现有文献以及关于美沙酮诱导尖端扭转型室速的预防和管理的当前概念。此外，我们还探讨了美沙酮诱导的QT间期延长与尖端扭转型室速之间遗传联系的观点及其影响。
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